NPI: 1720746688 · FREMONT, NE 68025 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 685 | $28K |
| 2023 | 1,180 | $49K |
| 2024 | 2,384 | $101K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 686 | 638 | $49K | |
| 92340 | 870 | 853 | $39K | |
| V2100 | Lens spher single plano 4.00 | 894 | 880 | $34K |
| V2020 | Vision svcs frames purchases | 924 | 898 | $29K |
| 92014 | 208 | 183 | $12K | |
| 92015 | 488 | 415 | $8K | |
| V2200 | Lens spher bifoc plano 4.00d | 57 | 57 | $4K |
| 92002 | 58 | 57 | $2K | |
| 92341 | 26 | 26 | $1K | |
| V2784 | Lens polycarb or equal | 38 | 38 | $288.96 |